| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
790 |
703 |
$44K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
329 |
306 |
$25K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
467 |
244 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
97 |
97 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
30 |
25 |
$2K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
239 |
222 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
13 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
44 |
39 |
$400.53 |
| 99173 |
|
34 |
27 |
$298.24 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
15 |
12 |
$103.37 |
| 96127 |
|
202 |
184 |
$0.00 |
| 92587 |
|
23 |
16 |
$0.00 |